Apps
Hemepath
→
neoplastic
→
lymphoid
DLBCL NOS
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Clinical
25-30% of adult non-Hodgkins
median age 70s
association: immunodeficiency, EBV
Morphology variants
centroblastic: most common, multiple nucleoli
immunoblastic: single central nucleoli
anaplastic: really large and bizzare cells
rare variants
Subtype
germinal center type
CD10 > 30% or
BCL6+, MUM1-
non-germinal center type
Panel
B markers
CD10
BCL6
MUM1
Ki67
BCL2, cMyc (to identify double hit)
Molecular
30% have 3q27 BCL6 abnormality
20% have t(14;18) like follicular lymphoma
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Diffuse large B cell lymphoma, not otherwise specified, see comment
Comment
The lymphoma has a *** germinal center immunophenotype
The Ki67 proliferation index is ***%, BCL2 stains ***% of the neoplastic cells, and c-Myc intensely stains approximately ***% of the neoplastic cells
Routine cytogenetic studies are pending